Healthsun Provider Appeal Dispute Form

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Health Sun HEALTH PLANS 9250 W. Flagler st. Suite # 600

Details: Health Sun HEALTH PLANS 9250 W. Flagler st. Suite # 600, FL 33174 Health Provider Appeal/Dispute Form Member Name: Claim# Appeal Requestor Address: Date: Date of Service. Appeal Requestor Name: Member ID: Provider Name. Appeal Requestor Phone: Please note the following in order to avoid delays in processing provider appeals: healthsun health plans provider portal

› Verified 5 days ago

› Url: https://healthsun.com/wp-content/uploads/2021/09/provider-appealdispute-form-01072021plus-1.pdf Go Now

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Provider Claims Dispute Form - healthsun.com

Details: Please return completed form with all relevant supporting documentation to: HealthSun Health Plans, Audit & Recovery Department, Disputes Unit at 9250 W. Flagler Street, Suite 600 Miami, FL 33174; or by e-mail, [email protected]healthsun.com H5431_AR_DISPUTE FORM_ENG Rev. Date 09.2021 healthsun for providers

› Verified 8 days ago

› Url: https://healthsun.com/wp-content/uploads/2021/09/Provider-Dispute-Letter_Rev-09.2021.pdf Go Now

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Forms & Documents for Providers - Your South Florida

Details: Provider Portal Access. To apply for access to the portal, please complete application provided below. Please note, if you are a non participating provider, you are required to fill out the BA Agreement provided below. Once all items have been filled out, please return … healthsun claims mailing address

› Verified 2 days ago

› Url: https://healthsun.com/for-providers/forms-documents/ Go Now

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Provider Dispute Form - Sunshine Health

Details: PROVIDER DISPUTE FORM Use this form as part of Sunshine Health's Provider Dispute process to request review of claim and non-claim matters . NOTE: Non-Claim disputes must be submitted 45 calendar days from the original date the issue(s) occurred. Claim disputes must be submitted 90 calendar days from the final determination or health access healthsun

› Verified 7 days ago

› Url: https://www.sunshinehealth.com/content/dam/centene/Sunshine/pdfs/Provider-dispute-form-011719.pdf Go Now

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- HealthSun Health Plans

Details: Enrollment in HealthSun Health Plans depends on contract renewal. Every year, Medicare evaluates plans based on a 5-star rating system. HealthSun complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. healthsun find doctor

› Verified 1 days ago

› Url: https://provider.healthsun.com/ Go Now

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Your South Florida Medicare Provider - HealthSun Health

Details: HealthSun Health Plans is an HMO plan with a Medicare Contract and a Medicaid contract with the State of Florida Agency for Health Care Administration. Enrollment in HealthSun Health Plans depends on contract renewal. Every year, Medicare evaluates plans based on a 5-star rating system. healthsun provider search

› Verified 2 days ago

› Url: https://healthsun.com/ Go Now

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Provider Dispute Resolution Request

Details: Mail the completed form to the following address. Please note the speciic address for all Medi-Cal appeals. Health Net Commercial Provider Appeals Unit PO Box 9040 Farmington, MO 63640-9040 Commercial Provider Services Center 1-800-641-7761 Health Net Medi-Cal Provider Appeals Unit PO Box 989881 West Sacrament, CA 95798-9881 healthsun claims address

› Verified 4 days ago

› Url: https://providerlibrary.healthnetcalifornia.com/content/dam/centene/healthnet/pdfs/providerlibrary/42462-Provider%20Dispute%20Resolution%20Request%20-%20Commercial%20and%20Medi-Cal.pdf Go Now

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PROVIDER DISPUTE RESOLUTION REQUEST

Details: Multiple “LIKE” claims are for the same provider and dispute but different members and dates of service. For routine follow-up, please use the Claims Follow-Up Form instead of the Provider Dispute Resolution Form. Mail the completed form to: XXX P.O. Box XXX City, CA XXXXX DISPUTE TYPE

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› Url: http://www.healthsmartmso.com/downloadfile/Clms_PDR_Form.pdf Go Now

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